[A study of bleeding peptic ulcer in the elderly in the view of risk factors]

We treated 448 patients for peptic ulcer from 1970 to 1988. Among them, 52 cases were bleeding peptic ulcer in the elderly. 32 cases (61.6%) had a duration of illness of less than 3 months, and the most common symptom was abdominal pain (51.9%). 22 cases (44.0%) were in shock and 32 cases (62.7%) had accessory diseases. Twelve cases were treated medically, while 40 cases were treated surgically. Elective operations were performed in 15 cases, and their mortality was 6.7%. Emergent operations were performed in 25 cases, and their mortality was 28.0%. The mortality of of cases involving both shock and accessory diseases was 57.1%, and of this group, all 3 cases treated medically died. When bleeding exceeded 2000cc was the mortality 46.7%. Regarding cases of emergent operation involving shock or accessory diseases, the mortality was 18.2% in the cases treated medically for less than 4 days and had the episodes of massive bleeding less than 3 times, but 62.5% in other cases. The results of this study suggest that aggressive surgical treatment in an early stage may reduce the mortality in elderly patients with peptic ulcer.